Long-Term Care - Illinois General Assembly

The Illinois Medicaid program, in partnership with other agencies (the Departments of Human
Services and Aging) has a variety of home and community-based programs. Over 51,000
seniors and persons with disabilities are served in these alternative settings. That's 51,000
Medicaid individuals. Several of the programs, such as the Community Care Program, also
provide services for non-Medicaid individuals. That translates to about half-and-half,
considering the 56,000 people being in nursing homes and 51,000 individuals being in
community settings.
The department has in the last few years instituted an innovative program known as the
Supportive Living Program — a form of assisted living. It helps seniors have one more option.
There are currently 29 supportive living facilities in operation, and another 41 sites under
development. This type of care promotes personal choice, dignity, privacy and individuality for
residents who use that service.
Illinois took advantage a few years ago of a waiver that the Federal government allowed for
implementation of the Senior Care (Rx) Program, which allows us to provide comprehensive
drug coverage to Illinois seniors up to 200% of poverty. The Governor would like expand
eligibility to people with incomes up to 250% of the federal poverty level. Illinois has applied for
this expansion with the Federal government, but it has not yet been approved.
The Senior Care (Rx) Program is a very comprehensive drug benefit. Compared to prescription
drug proposals under consideration at the federal level for Medicare, it is a much more
generous program. There is no enrollment fee. There is no deductible. There is $1 co-pay for
generic drugs and $4 for brand names, up to a level of spending of $1,750. After that threshold
is reached there is 20% co-pay. It is a very generous program.
Marta Sayeed
Illinois Department of Human Services
The Home Services Program is housed in the Office of Rehabilitation Services within the
Department of Human Services. The program is required to serve people who have disabilities
between the ages of birth to 59, to help prevent institutionalization and, in many instances,
come out of a nursing home. The goal is to provide community services. This is a Medicaid
waiver program.
The Home Services Program began in 1979 as a very small program at the Department of
Public Aid. It was transferred to the then Department of Rehabilitation Services. It was a very
small program. We served 1,200 people. In the early 1980s, the Medicaid waiver was
obtained, and the caseload has grown to 27,000 by the end of this year.
Since the program’s inception, it has been based on the concept of customer choice. The
majority receive home services, but given by personal care attendants. Those attendants are
chosen by the customer, which means they are hired, trained, directed, and, if it doesn't work
out, fired by the individual customer. It puts control of the services with the recipient.
One of the advantages of being in the Department of Human Services, together with the rest of
a number of disability services, is that customers also have direct access to other services,
including the vocational rehabilitation program that relates to some of the same customers. This
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